The quasispecies nature of hepatitis B and C virus (HBV, HCV) plays an important role in the pathogenesis, immune escape and drug resistance during chronic infection. Although there is still a lack of effective treatment for hepatitis C, a series of nucleoside analogs (NA) have been developed for the treatment of hepatitis B. NA resistant HBV mutants can accumulate during prolonged therapy and lead to the failure of anti-HBV therapy. Switching to other sensitive NAs can inhibit the emerged resistant mutants. Therefore, understanding the evolution of viral quasispecies under drug pressure is crucial for the establishment of antiviral strategy and the monitoring of antiviral process. Immune response and escape are complicated process, during which both host and virus factors may play their roles. Further understanding of the interaction and interrelationship between host and these viruses may lead to optimized prevention, diagnosis and treatment for chronic hepatitis.

Objective To investigate the relationship of the aneurismal occurrence with bifurcation angle in the horizontal section(M1) of middle cerebral artery .Methods Totally 24 cases which were diagnosed as one‐side aneurysm in bifurcation angle of middle cerebral artery with 3D‐CTA were studied retrospectively and confirmed by 3D‐DSA or surgery from January 2012 to June 2013 .The measurement of daughter‐to‐daughter branch angles with the ill and the normal side were performed on the work‐station .The size of the ill and normal side were expressed as γ1 and γ2 ,respectively .Statistical analysis was performed using SPSS20 .0 for windows .Results The mean value of γ1 was (129 .48 ± 22 .38)° ,whileγ2 was (111 .33 ± 20 .90)° .The mean value ofγ1 -γ2 was (18 .15 ± 3 .10)° .There was significant difference between the ill side and normal side (t=2 .868 ,P=0 .009) .Conclu‐sion Larger daughter‐to‐daughter branch angles are associated with the presence of middle cerebral artery bifurcation aneurysms . This easily measurable parameter may provide objective metrics to assess aneurysm formation .

In this article, we summarize the main policy on encouraging nongovernmental investors to establish medical institutions in Wenzhou , Zhejiang Province.Based on the survey of private medical institutions in Wenzhou , we find that there are still many issues that should be resolved in terms of nongovernmental investors establishing pri -vate hospitals , such as the difficulty in implementing construction projects , spending too long time applying for the medical insurance unit , the complicated application procedures of incentive funds , the unequal status with public health hospitals in financing and the development of human resource for health , and the low-level administration and social reputation.Therefore , for promoting the sustainable development of private health hospitals , it is of great im-portance to have a breakthrough in the implementation of the policy ,such as supporting policies reform , financing and talent support , strengthening supervision , and so on.

Aged ; Atrial Fibrillation ; surgery ; Catheter Ablation ; adverse effects ; Female ; Heart Injuries ; etiology ; Humans ; Iatrogenic Disease ; Syndrome

The mammalian TOR ( mTOR ) pathway is a key regulator of cell growth and proliferation which is also a fundamentally important player in a large variety of human diseases. The pathway regulates many key cellular processes and is implicated in a large number of pathological conditions, including cancer, obesity, diabetes, and cardiovascular disease, age - related diseases and other proliferative disease. It integrates signals from nutrients, energy status and growth factors to regulate many processes, including autophagy, ribosome biogenesis and metabolism. Our article reviews the advancement of laboratory results on mTOR pathway in proliferative diseases in ophthalmology.

Objective The role of testis-sparing surgery in children with benign testicular tumors were emphasized by this retrospective survey. Methods Sixteen patients who undergo testis-sparing surgery between the years 1996 to 2003 were reviewed. Intraoperative frozen section histopathology had been done in all of patients. The period of follow-up ranged from 6 months to 7 years. Results In our series, as well as in the literature there was no differenle between frozen section and definitive histology.Ten cases were teratomas, 4 cases were epidermoid cysts and 2 cases were mucus cysts.Follow-up of 6 months to 7 years has shown no recurrence,and on examination,testicular volume is normal in all cases.Conclusion Testis-sparing surgery is a positive method in the management of benign testicular tumors in children.It preserves testicular volume,which is important for both cosmetic and functional roles.

Whole brain radiation therapy has become the standard treatment of non-small cell lung cancer (NSCLC) with brain metastasis,because it prolongs the survival times of NSCLC patients with brain metastases.The emergence of molecular targeted drugs is a major innovation in the traditional sense of the cancer treatment.Molecular targeted drugs have many advantages such as convenient dosing,rapid onset,improving the intracranial and extracranial tumor lesions at the same time,mild adverse reactions and good tolerance,which provide a new and better choice for the treatment of NSCLC patients with brain metastases.

Objective To investigate the level and influence factors of sleep quality in caregivers to neurological intensive care unit (NICU) survivors. Methods The Pittsburgh Sleep Quality Index (PQSI) and the sleep quality influence factor scale were administered on 167 family caregivers to NICU survivors. Results The score of PQSI was 8.81 ± 3.25,and 55.68%(98/167) of caregivers reported poor sleep quality. Logistic regression analysis showed that medical insurance(OR=2.025, P<0.01), hospital stay (OR==2.235, P<0.01), whether caregivers in service (OR=0.583, P<0.05), resisdence(OR=2.341, P<0.01), and tracheal tubes/ventricular drainage (OR=5.857, P<0.01) were influencing factors of sleep quality. Conclusions It proved that our intervention should focus on family caregivers to NICU survivors social and psychological characteristics may help to enhance their sleep quality and quality of life.

30%-50% patients with non-small cell lung cancer (NSCLC)will occur cerebral metastasis in the course of their illnesses.NSCLC with brain metastases is one of the difficulties in cancer treatment. Treatment measures include surgery,radiotherapy,chemotherapy,biological targeted therapy and so on.The new prognostic scoring system is recommended to predict the prognosis of patients.Individualized treatment methods should be chosen according to prognostic score.

Objective To develop the security scale of college students' sense to investigate college students' subjective feeling of security.According to the characteristics of the feeling tendentiousness to analysis the subject and object factors influencing the insecurity of college students.Methods The security scale of college students' sense compiled was administrated to 500 college student randomly stratified cluster sampling from four universities in Yantai,then description and analysis were analyzed by SPSS17.0,AHP and SAS9.1 to statistical.Results Through the scale of exploratory factor analysis,the Cronbach' s of the scale was 0.629.College students in four dimensions of security and total security were in above-average levels,college students' total scorc of security is significance of difference in grade,gender and whether come from the single parent(all P＜0.05) ;Self security was significance of difference in the grade and the gender(P＜0.01 and P＜0.05) ; and interpersonal security in gender and whether come from the single parent had significance difference(P＜0.05) ;Determine control and family security in these demographic variable aspects had no significant differences.Multivariate factors analysis results showed that the decision tree model was better than the logistic model (the misclassification rate of the model was lower than the decision tree model).The main factors affecting the university students' security were gender,grade,the average income and whether they,were the only children.The misclassification rate of the decision tree model was lower than the model of logistic.College students' sense of dimensions are significant with positive correlation,the dimension of the security level may affect other security of the situation.Conclusion The security scale of college students' sense has good reliability and validity and can be used in the study of college security.The factor analysis determines it can be used multiple factors analysis.The survey shows that the overall security of the crowd' s is over the average level.The gender,grade,annual per-capita income and whether the one-child are the potential factors that affect college students' insecurity.